The Work Environment during Coronavirus Epidemics and Pandemics: A Systematic Review of Studies Using Quantitative, Qualitative, and Mixed-Methods Designs

Functioning of post-COVID-19 patients: a cross-sectional study at the outpatient clinic for long-term effects

BACKGROUND

After COVID-19 infection, long-term impacts on functioning may occur. We studied the functioning of patients with post-COVID-19 condition (PCC) and compared them to controls without PCC.

METHODS

This cross-sectional study consisted of 442 patients with PCC referred to rehabilitation at the Helsinki University Hospital (HUS) Outpatient Clinic for the Long-Term Effects of COVID-19, and 198 controls without PCC. Functioning was assessed with a questionnaire including WHODAS 2.0. Patients underwent physical testing including a hand grip strength test (HGST) and a 6-minute walking test (6MWT). Lifestyle was assessed by questionnaire and comorbidities were collected as ICD-10 codes from the HUS Data Lake on the HUS Acamedic platform.

RESULTS

The WHODAS 2.0 average total score was 34 (SD 18) (moderate functional limitation) for patients with PCC and 6 (SD 8) (normal or mild limitation) for the controls. The disability was higher in all aspects of WHODAS 2.0 in patients with PCC. Bivariate binomial and multivariable regression analyses showed that the presence of comorbidities, anxiety, depression, and smoking predicted a WHODAS 2.0 score of 24 (moderate functional limitation) or above in the PCC group. The average 6MWT distance was 435 m (SD 98 m) in patients with PCC and 627 m (SD 70 m) in controls. HGST measurements showed no significant differences from controls.

CONCLUSIONS

In conclusion, patients with PCC had significantly reduced functioning based on WHODAS 2.0 scores and the 6MWT results. Comorbidities, anxiety, depression, and smoking were associated with moderate or severe limitations in functioning. Findings support that PCC is multifactorial and requires a holistic approach to rehabilitation.

Occupational pressures of frontline workers enforcing COVID-19 pandemic measures in Ontario and Quebec, Canada

BACKGROUND

During the COVID-19 pandemic, low-wage public-facing frontline workers (FLWs), such as grocery store clerks, were required to monitor retail customers and enforce COVID-19 protocols.

OBJECTIVE

This analysis aimed to examine FLWs experiences of enforcing COVID-19 pandemic measures.

METHODS

Between September 2020 and March 2021, in Ontario and Quebec (Canada), we conducted in-depth interviews about customer-related work and health risks with FLWs who interacted with the public (n = 40) and their supervisors (n = 16). Using a lens of situational analysis, verbatim transcripts were coded according to recurring topics.

RESULTS

We found that enforcing public health measures placed already-precarious workers in difficult occupational health circumstances. Enforcement of measures created additional workplace responsibilities, stress, and exposed them to potentially negative reactions from customers.

CONCLUSIONS

Interventions to better support these workers and improved methods of protection are discussed.

From Threatening Chaos to Temporary Order through a Complex Process of Adaptation: A Grounded Theory Study of the Escalation of Intensive Care during the COVID-19 Pandemic

To ensure high-quality care, operationalize resilience and fill the knowledge gap regarding how to improve the prerequisites for resilient performance, it is necessary to understand how adaptive capacity unfolds in practice. The main aim of this research was to explain the escalation process of intensive care during the first wave of the pandemic from a microlevel perspective, including expressions of resilient performance, intervening conditions at the micro-meso-macrolevels and short- and long-term consequences. A secondary aim was to provide recommendations regarding how to optimize the prerequisites for resilient performance in intensive care. A grounded theory methodology was used. First-person stories from different healthcare professionals (n70) in two Swedish regions were analyzed using the constant comparative method. This resulted in a novel conceptual model (including 6 main categories and 24 subcategories), and 41 recommendations. The conclusion of these findings is that the escalation of intensive care can be conceptualized as a transition from threatening chaos to temporary order through a complex process of adaptation. To prepare for the future, the components of space, stuff, staff, system and science, with associated continuity plans, must be implemented, anchored and communicated to actors at all levels of the system.

Covid-19: Home Health Aides' Perceived Preparedness and Self-Reported Availability for Work: Six Month Survey Results

Throughout the COVID-19 pandemic New York City home health aides continuously provided care, including to patients actively infected or recovering from COVID-19. Analyzing survey data from 1316 aides, we examined factors associated with perceptions of how well their employer prepared them for COVID-19 and their self-reported availability for work (did they "call out" more than usual). Organizational work environment and COVID-19-related supports were predominant predictors of self-reported perceptions of preparedness. Worker characteristics and COVID-19-related stressors were predominant predictors of self-reported availability. Mental distress, satisfaction with employer communications, and satisfaction with supervisor instructions were significantly associated with both outcomes. The study uniquely describes self-reported perceptions of preparedness and availability as two separate worker outcomes potentially modifiable by different interventions. Better public health emergency training and adequate protective equipment may increase aides' perceived preparedness; more household supports could facilitate their availability. More effective employer communications and mental health initiatives could potentially improve both outcomes. Industry collaboration and systemic changes in federal, state, and local policies should enhance intervention impacts.

Prevalence and Factors Associated with Mental Health Problems among Essential and Nonessential Workers during the COVID-19 Pandemic, June 2021, in an Unstable and Developing Country: A Cross-Sectional Study

The two main goals of this research were to assess workers’ mental health (anxiety, depression, and job burnout syndrome) and examine factors related to mental health burdens in two groups of workers. The study was conducted as an online cross-sectional study. The target population consists of workers in essential activities who worked during the pandemic (health, defense, trade, finance, and media), as well as a group of workers who were particularly impacted by the protection measures and either worked under a different regime or were unable to work (caterers, musicians). A questionnaire was constructed for the needs of this research and the scales for anxiety, depression, and burnout syndrome were used. In total, 42.2% of non-essential workers and 39.5% of essential workers reported anxiety symptoms, circa 20% of non-essential activity workers and essential activity workers reported depression, and 28.9% of non-essential activity workers and 33.7% of essential activity workers reported burnout. A significant association has been found between certain sociodemographic and health characteristics of respondents, as well as financial stress (worry about losing a job), social stress, media stress, and respondents’ trust in competent authorities and COVID-19 prevention measures, and symptoms of anxiety, depression, and burnout syndrome. The findings of this study pointed to mental health issues in other activities and highlighted the need for and importance of examining mental health in the population of non-essential activities. It is indicative of significant points that can be investigated in the future for prevention.